Abstract
>Objective: To describe the fetal heart rate (FHR) patterns of 300 term brain-damaged infants.Methods: The fetal monitor strips of 300 singleton term neurologically impaired neonates were retrospectively analyzed.Results: Of the 300 infants, the admission FHR patterns were: reactive, 152 (51%); nonreactive, 135 (45%); bradycardia, 9 (3%); or unclassifiable, 4 (1%). In the reactive group, the FHR did the following: 1) remained reactive throughout labor [24 (16%)]; 2) developed an elevated baseline FHR in association with repetitive FHR decelerations and, in most instances, a loss of variability [67 (22%)]; or 3) developed a sudden prolonged FHR deceleration that lasted until delivery [61 (20%)]. Finally, the nonreactive admission group exhibited the following: 1) a persistent fixed baseline rate from admission (149 +/- 16 beats/min) [97 (72%)]; 2) a prolonged FHR deceleration that lasted until delivery [12 (9%)]; or 3) a stair steps to death pattern [26 (19%)].Conclusions: While term infants later found to be neurologically impaired do not manifest a uniform FHR pattern, these fetuses do manifest distinct FHR patterns intrapartum that can be easily categorized and identified on the basis of the fetal admission test and subsequen...Continue Reading